Hemorrhagic Changes Research Articles

Ancient Schwannoma in Proximity to the Median Nerve in the Midarm of an Elderly Woman

ABSTRACT Ancient schwannomas (ASs) are a rare type of schwannomas which arise from the Schwann cells. They are characterized by benign nature and long-standing course. Their histopathological hallmark is hemorrhagic and degenerative changes with nuclear atypia. They can be misdiagnosed as malignant tumors but are differentiated by absence of mitotic activity. The median nerve in the arm is rarely involved. Even rarer is the appearance of ASs away from the main median nerve. We describe a case of AS present in proximity to the median nerve in the midarm of an elderly woman. The tumor grew relatively faster over 1.5 years and the patient presented with pain and swelling in the medial side of the right midarm. Following imaging and histopathological examination (HPE), definitive diagnosis was reached. Surgical excision was done performed and further HPE confirmed AS. The patient was further subjected to external beam radiotherapy (RT; 50 Gy over 5 weeks in 25 fractions) to prevent recurrence. RT was well tolerated, and at 2 months of follow-up, there was absence of any radiological sign of recurrence. The differential diagnoses of AS include sarcomas and tumors of neural origin. History, clinical presentation, imaging, and histopathology findings are critical in arriving at the diagnosis of AS.

Genetic framework sequencing analysis of Candida tropicalis in dairy cow mastitis and study of pathogenicity and drug resistance

Candida tropicalis (C. tropicalis) is a zoonotic pathogen that is widespread in the environment and in recent years an increasing number of dairy cows have been infected with the fungus causing mastitis in cows.In this study, 37 milk samples from the udders of cows with clinical mastitis were collected from a dairy farm in Guangxi Province, China, from which C. tropicalis was isolated and identified, and then the isolated fungi were subjected to genome frame map sequencing, genome functional analysis as well as comparative genome analysis of the sequencing results, and combined with the virulence test of the fungi and drug sensitivity test of the fungi determined in infected mice, the resistance genes and pathogenicity of the fungi were Analysis of resistance genes and pathogenicity.Our study results revealed the isolation and characterisation of C. tropicalis from diseased cows, with a genome length of approximately 14.27 Mb. Functional annotation of the genome identified 4068 genes associated with C. tropicalis. The strain exhibited a chemoresistance mutation in the gene cyp51,a virulence-enhancing mutation in the gene VTC4, and mutations in genes linked to drug resistance. Pathogenicity tests demonstrated that C. tropicalis could induce damage to the internal organs of mice, leading to different levels of cyanosis in the abdominal cavity, white necrotic foci on the surface of internal organs, lung hemorrhage, and enlargement of the spleen and thymus.Histological sections also revealed varying degrees of hemorrhage and degenerative changes in the cells of different organs in the mice. Drug sensitivity tests showed that the fungus was highly sensitive to nystatin and ketoconazole, moderately sensitive to amphotericin B, and insensitive to antibiotics such as itraconazole, gentamicin, and penicillin. In conclusion, C. tropicalis isolated from dairy cows in the Guangxi region in this study was pathogenic and resistant to azoles such as itraconazole and fluconazole, and this study provides a theoretical basis for the further screening of novel resistance genes in C. tropicalis, as well as providing a certain reference for the drugs used for the treatment of fungal cow mastitis in this region.

Progressive T1 high-intensity plaques in carotid stenosis: Comparative MRI analyses in asymptomatic and symptomatic phases of low-grade stenosis

Background and PurposeCarotid artery stenosis, particularly the progression from asymptomatic to symptomatic lesions, is a key factor in cerebrovascular events. This study identifies predictors of symptom development in low-grade carotid stenosis (<50%), focusing on intraplaque hemorrhage (IPH) and dynamic plaque changes. Materials and MethodsWe conducted a retrospective study analyzing 30 cases of symptomatic low-grade carotid stenosis, using carotid MRI before and after symptom onset. Key measures included relative plaque signal intensity (rSI) and high-intensity plaque (HI plaque) volume. Stepwise regression analysis examined the influence of these factors on Symptomatic rSI, Symptomatic plaque volume, and NIHSS scores. ResultsSignificant increases were observed in rSI (1.32 ± 0.32 to 1.69 ± 0.25, p < 0.001) and HI plaque volume (296.4 ± 362.7 mm³ to 717.5 ± 554.9 mm³, p < 0.001) from asymptomatic to symptomatic phases. Past smoking (p = 0.008) and statin use (p = 0.04) were associated with higher Symptomatic rSI, while poor risk factor control (p = 0.03) was negatively associated. Female sex (p = 0.007) and current smoking (p = 0.009) were linked to smaller Symptomatic plaque volumes, while ischemic heart disease (p = 0.0002) and poor risk factor control (p = 0.002) predicted larger plaque volumes. Larger plaques were correlated with higher NIHSS scores (p = 0.002). ConclusionsIPH and plaque volume are key markers of progression in low-grade carotid stenosis. Poor control of cardiovascular risk factors and a history of ischemic heart disease contribute to plaque burden and stroke severity. Continuous monitoring and strict risk management are essential in reducing stroke severity in these patients.

Trends over time in oral anticoagulation and stroke rates in atrial fibrillation: A community-based study

ObjectivesOver the last decade, direct oral anticoagulants (DOAC) have become preferred over warfarin for stroke prevention in atrial fibrillation (AF). The objectives of this study were to quantify the shift over time from warfarin to DOACs and parallel changes in ischemic and hemorrhagic stroke rates in AF. Materials and methodsThis community-based retrospective study was undertaken within a single integrated health care network from 2011 to 2021. Changes over time in warfarin and DOAC use were quantified by year, both overall and stratified by CHA2DS2-VASc score. Ischemic and hemorrhagic stroke rate changes over time were evaluated by Poisson regression. Stroke rates were evaluated in different time eras: 2011–2015 and 2016–2021. ResultsAmong 31,978 AF patients followed an average of 5.5 years, any OAC use increased from 50.2 % (2011) to 59.4 % (2020) (p < 0.001). Warfarin use decreased from 49.3 % to 30.8 %, while DOAC use increased from 2.0 % to 30.8 % (both p < 0.001). In 2020, patients with CHA2DS2-VASc 0–1 and 2–5 were more likely to use DOACs than warfarin (18.6 % vs. 6.7 %; 33.0 % vs. 28.2 %), whereas in CHA2DS2-VASc 6–9 DOACs were used less frequently (30.0 % vs. 40.8 %). Ischemic stroke rates significantly increased by 19 % (95 % CI: 7 %, 32 %) from 2011 to 2015, but significantly decreased by 18 % (10 %, 26 %) from 2016 to 2021. Hemorrhagic stroke rates stabilized in 2016–2021 (+3 %; −18 %, 30 %) after increasing in 2011–2015 (+36 %; 4 %, 78 %). ConclusionImprovements in ischemic and hemorrhagic stroke rates coincided temporally with increased uptake of OACs and a shift toward increased uptake of DOACs relative to warfarin.

To Evaluate The Histomorphological Changes Of Postmortem Transthoracic Needle Biopsy/Autopsy Lung In COVID-19 Patients

Objective: To study the histomorphological changes in postmortem needle biopsy/autopsy lung in COVID-19 Patients. Study Design: This was an observational study done at Shri Atal Bihari Vajpayee Medical College &amp; Research Institute, Bengaluru, and Karnataka from March 2021 to May 2021. Methodology: A total of 30 patients who died of Covid-19 were included and all of them were diagnosed to be Covid -19 positive by RT-PCR testing. Post-mortem transthoracic needle biopsy was done to obtain lung tissue by using B-Bard biopsy gun in midaxillary approach. The biopsy samples were grossed and processed after fixing for 48hrs. The slides obtained were stained by routine hematoxylin and eosin stain, studied for morphology of the lung tissue and findings were recorded. Results: We obtained consent for post-mortem transthoracic needle biopsy/autopsy of lung in 30 deceased cases. All these cases were positive for SARS –COV2 on RT-PCR. The age of the cases was ranging from 26-72 years and median age is 53years, males (63.3%) were affected more than females (36.7%). Most deceased had comorbidities, among them diabetes mellitus (26.6%) and hypertension (26.6%) were most common. Lung biopsy samples were taken from 30 deceased patients. Histomorphological feature of diffuse alveolar damage was seen in 90% (27 out of 30) cases. Other findings noted on microscopy were chronic interstitial inflammation in 6.7% cases, pulmonary edema (3.33%), intra alveolar haemorrhage (3.33%) and viral cytopathic changes (3.33%). Conclusion: This study highlighted the pulmonary morphological changes which are most prominent in COVID-19 infections, but it was a difficult to ascertain that the findings are related to viral infection or due to associated coomorbidities

The Correlation between Doppler Assessment of Cerebral Blood Flow Changes and Common Neonatal Intracranial Lesions

Abstract Background Transcranial ultrasonography, in experienced hands, is an outstanding tool to detect brain abnormalities in preterm and full-term infants, and to follow the progression of these lesions. Doppler sonography is an excellent modality for assessment of the cerebral vasculature in the newborn and provides valuable information about cerebral vascular anatomy. Aim and Objectives to discuss the value added by transcranial Doppler assessment of blood flow in major intracranial cerebral arteries to brain status evaluation in neonatal intracranial hemorrhagic and ischemic conditions by employing Doppler techniques. Subjects and Methods This was a prospective cohort study that was carried out at tertiary care centers.45 neonates admitted to the neonatal intensive care unit were enrolled based on having the clinical diagnosis of perinatal asphyxia and having ischemic and hemorrhagic cerebral changes on grey scale sonographic evaluation. Doppler interrogation of both anterior cerebral artery (ACA) and middle cerebral artery (MCA) was performed bilaterally. Follow up evaluation was performed upon discharge. It was conducted from October 2022 to April 2023. Results There was a statistically significant difference between the studied groups as regard (APGAR Score at 1 min and 5 min), (peak systolic velocity (PSV) (cm/s) of ACA and resistive index (RI)), (peak systolic velocity (PSV) (cm/s) of MCA and resistive index (RI)), Correlation between Severity of hemorrhagic and ischemic cerebral changes with other studied Parameters except in gestational age and body weight. Conclusion Ultrasonographic features and cerebral blood flow parameters are useful for the early diagnosis of hypoxic-ischemic encephalopathy and help predict outcome. In the presence of more extensive hypoxic-ischemic brain injury and statistically significantly lower peak systolic velocity and higher resistive index in the anterior and medial cerebral arteries, the outcomes were poorer.

Diabetic Ketoacidosis and Sepsis: A Diagnostic Challenge

Diabetic ketoacidosis is the most common complication of diabetes mellitus; infection can be a precipitating factor in almost 50% of cases. Description of the Case Report: A 74-year-old woman with type 2 diabetes was admitted at our emergency department for an alteration of consciousness, afebrile, abdominal rush with an eschar and a vesicular rash extended to the entire left arm. The patient had severe metabolic acidosis with glucose of 720 mg/ dL and hyperlactatemia. Restoration of intravascular volume and correction of electrolyte abnormalities, acidosis and hyperglycemia were carried out. After 20 minutes she had a worsening of the consciousness state (GCS 8). A non-contrast head CT was negative for acute hemorrhagic or ischemic changes, and an EEG was free of clear epileptiform abnormalities. Neck examination showed rigidity in flexion and doubtful meningeal signs. Due to the high index of suspicion, lumbar puncture was performed that revealed clear cerebrospinal fluid (CSF), hyperglycorrhachia, proteinorrhachia, pleocytosis. Empirically, patient was started with Acyclovir. CSF -PCR was positive to the Varicella Zoster Virus, leading to the diagnosis of Herpetic Encephalitis. Conclusions: Encephalitis can occur without fever. Alteration of consciousness, common to both diabetic ketoacidosis and encephalitis, can be a confounding factor for a correct diagnos

Possible protective effect of remifentanil against testicular ischemia-reperfusion injury

Abstract Objectives This study aims to evaluate the protective efficacy of remifentanil against testicular ischemia-reperfusion injury. Methods The study included 24 male rats. The rats were randomized into three groups: Group 1 was the control group. Group 2 was subjected to a testicular torsion/detorsion model. Group 3 underwent similar procedures and additionally received remifentanil (0.6 μg/kg/min) intravenously for the first 20 min of reperfusion. Blood samples were taken for biochemical analyses, and orchiectomy was performed for histopathologic examination. Results Biochemical analysis of blood samples showed a significant increase in antioxidant enzyme activity, including superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in Group 3 compared to Group 2 (p:0.004 and p:0.002, respectively). There was a dramatic decrease in the levels of proinflammatory cytokines, including interleukin-1 beta (IL-1 Beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in Group 3 compared to Group 2 (p:0.001, p:0.046, and p:0.004, respectively). Similarly, malondialdehyde (MDA) levels decreased in Group 3 compared to Group 2 (p:0.004). Histopathologic examination of Group 3 rats showed positive changes in inflammation, hemorrhage, edema, and congestion levels compared to Group 2 (p&lt;0.001). Similarly, there was a positive effect on the Johnsen and Cosentino score in Group 3 compared to Group 2 (p:0.001 and p&lt;0.001, respectively). Conclusions In our study, it has been documented that remifentanil protects against testicular ischemia-reperfusion injury.

Erratum: Dynamic Changes in Intracerebral Hemorrhage during Computed Tomography Scanning after Stent Implantation of Middle Cerebral Artery.

Erratum: Dynamic Changes in Intracerebral Hemorrhage during Computed Tomography Scanning after Stent Implantation of Middle Cerebral Artery.

Stereotactic Radiosurgery With Versus Without Neoadjuvant Endovascular Embolization for Brain Arteriovenous Malformations With Associated Intracranial Aneurysms.

Stereotactic radiosurgery (SRS) with neoadjuvant embolization is a treatment strategy for brain arteriovenous malformations (AVMs), especially for those with large nidal volume or concomitant aneurysms. The aim of this study was to assess the effects of pre-SRS embolization in AVMs with an associated intracranial aneurysm (IA). The International Radiosurgery Research Foundation AVM database from 1987 to 2018 was retrospectively reviewed. SRS-treated AVMs with IAs were included. Patients were categorized into those treated with upfront embolization (E + SRS) vs stand-alone SRS (SRS). Primary end point was a favorable outcome (AVM obliteration + no permanent radiation-induced changes or post-SRS hemorrhage). Secondary outcomes included AVM obliteration, mortality, follow-up modified Rankin Scale, post-SRS hemorrhage, and radiation-induced changes. Forty four AVM patients with associated IAs were included, of which 23 (52.3%) underwent pre-SRS embolization and 21 (47.7%) SRS only. Significant differences between the E + SRS vs SRS groups were found for AVM maximum diameter (1.5 ± 0.5 vs 1.1 ± 0.4 cm3, P = .019) and SRS treatment volume (9.3 ± 8.3 vs 4.3 ± 3.3 cm3, P = .025). A favorable outcome was achieved in 45.4% of patients in the E + SRS group and 38.1% in the SRS group (P = .625). Obliteration rates were comparable (56.5% for E + SRS vs 47.6% for SRS, P = .555), whereas a higher mortality rate was found in the SRS group (19.1% vs 0%, P = .048). After adjusting for AVM maximum diameter, SRS treatment volume, and maximum radiation dose, the likelihood of achieving favorable outcome and AVM obliteration did not differ between groups (P = .475 and P = .820, respectively). The likelihood of a favorable outcome and AVM obliteration after SRS with neoadjuvant embolization in AVMs with concomitant IA seems to be comparable with stand-alone SRS, even after adjusting for AVM volume and SRS maximum dose. However, the increased mortality among the stand-alone SRS group and relatively low risk of embolization-related complications suggest that these patients may benefit from a combined treatment approach.

Biomarkers of hemorrhagic transformation of acute ischemic stroke – A cross-sectional study

Background. Hemorrhagic transformation (HT) is a serious complication that can arise in individuals experiencing acute ischemic stroke (AIS), whether it occurs spontaneously or following thrombolytic therapy, resulting in considerable morbidity and mortality. Hemorrhagic changes are associated with several risk factors, including excessive blood sugar levels, hypertension, the severity of a stroke, and reperfusion. Aim. To assess the commonly available blood parameters such as lipid profile, serum magnesium, and serum ferritin as tools to identify patients who are at risk of hemorrhagic transformation after an acute ischemic stroke. Materials and methods. The study was conducted at the Saveetha Medical College, Chennai, Tamil Nadu, in India, as a cross-sectional study, and a total of 142 patients diagnosed with acute ischemic stroke were enrolled for this study from January 2023 to January 2024. Results. Among the 32 patients who had a hemorrhagic transformation, all 32 (100%) patients had elevated serum ferritin levels and the remaining 110 patients who had no hemorrhagic transformation were found to have normal serum ferritin levels and the difference was statically significant (p&lt;0.001). Total cholesterol, serum LDL, serum HDL, and serum triglycerides had no statistically significant association with hemorrhagic transformation among the patients. Conclusion. The present study concludes that people with lower serum magnesium on admission and higher serum ferritin were found to be at risk. Serum lipid profile had no statistically significant association with hemorrhagic transformation among the patients.

Histopathological alterations caused by Klebsiella pneumoniae infection in rabbits and the preventive effects of whole sonicated killed antigen and Albizia lebbeck extract

Background. The purpose of this study is to estimate the protective capability of ethanolic Albizia lebbeck leaf extract against Klebsiella pneumoniae contagion in rabbits. Methods. The animals gathered into three groups each group contain eight albino rabbits were received the following: subcutaneously group one was received Killed Whole Cell Sonicated Antigen-Klebsiella pneumoniae (KWCSAg-KP); group two was orally received ethanolic Albizia lebbeck leaf extract and KWCSAg-KP subcutaneously; group three was quit as control group was given PBS subcutaneously. The rabbit groups were orally challenged by 1.5 × 108 CFU/ml Klebsiella pneumoniae then the rabbit were immolated ten days post-challenge for pathological changes. Spleen, liver, intestine and kidney were examined for histopathological alterations. Intestine, liver, kidney and spleen were examined for pathological changes. Results. The results revealed that the 2nd group had the least histopathological alterations with moderate infiltration of inflammatory cells in addition to no any abnormality detected in the kidney as well as the liver. The KWCSAg-KP group revealed sloughing with mild superficial inflammation in the lamina propria and mild vacuolation of the hepatocytes in the centrilobular area in addition to moderate white pulp hyperplasia in the spleen. The control group showed sever changes of inflammation, vacuolation, intestinal hemorrhage and congestion of the hepatic veins as well as hemosiderosis of the red pulp in the spleen. Conclusion. Albizia lebbeck leaf extract revealed to give an appropriate protection against inflammation as well as damage of virulent Klebsiella pneumoniae contagion in comparison to both of KWCSAg-KP and control groups.

Pleomorphic Xanthoastrocytoma: Multi-Institutional Evaluation of Stereotactic Radiosurgery

BACKGROUND AND OBJECTIVES: Pleomorphic xanthoastrocytoma (PXA) is a rare low-grade glial tumor primarily affecting young individuals. Surgery is the primary treatment option; however, managing residual/recurrent tumors remains uncertain. This international multi-institutional study retrospectively assessed the use of stereotactic radiosurgery (SRS) for PXA. METHODS: A total of 36 PXA patients (53 tumors) treated at 11 institutions between 1996 and 2023 were analyzed. Data included demographics, clinical variables, SRS parameters, tumor control, and clinical outcomes. Kaplan-Meier estimates summarized the local control (LC), progression-free survival, and overall survival (OS). Secondary end points addressed adverse radiation effects and the risk of malignant transformation. Cox regression analysis was used. RESULTS: A total of 38 tumors were grade 2, and 15 tumors were grade 3. Nine patients underwent initial gross total resection, and 10 received adjuvant therapy. The main reason for SRS was residual tumors (41.5%). The median follow-up was 34 months (range, 2-324 months). LC was achieved in 77.4% of tumors, with 6-month, 1-year, and 2-year LC estimates at 86.7%, 82.3%, and 77.8%, respectively. Younger age at SRS (hazard ratios [HR] 3.164), absence of peritumoral edema (HR 4.685), and higher marginal dose (HR 6.190) were significantly associated with better LC. OS estimates at 1, 2, and 5 years were 86%, 74%, and 49.3%, respectively, with a median OS of 44 months. Four patients died due to disease progression. Radiological adverse radiation effects included edema (n = 8) and hemorrhagic change (n = 1). One grade 3 PXA transformed into glioblastoma 13 months after SRS. CONCLUSION: SRS offers promising outcomes for PXA management, providing effective LC, reasonable progression-free survival, and minimal adverse events.

Formulation and Evaluation of Herbal Tablets from the Shimshin-6 Prescription and Its Effect on Postpartum Involution in Rats

The Shimshin-6 prescription has been used to treat female patients for blood clots, back and waist pain, and menstrual cramps. It is intended to support the recovery of the uterus after both childbirth and abortion. The purpose of this study is to create a tablet form of the Shimshin-6 formula and examine its effects on the recovery of the uterus after childbirth. The granules were developed using wet granulation, and the tablets were made using a direct compression method. Our test product in tablet form was manufactured following the quality parameters specified in the Mongolian National Pharmacopoeia. Shimshin-3 tablet was considered the best formulation; it used 5% cane sugar as a binder. In this study, Shimshin-6 treatment significantly reduced the uterus index and blood estrogen levels compared to the control group showing no difference in progesterone concentration. We found that Shimshin-6 decreased Tumor Necrosis Factor (TNFα) and regulated growth factors in postpartum rats. Shimshin-6 also regulated postpartum uterine recovery, as indicated by histological analysis. Our results showed the infiltration of inflammatory cell and hemorrhagic changes in the uterine wall. In conclusion, the formulation and evaluation of herbal tablets were satisfactory, and it has been found to enhance uterine recovery postpartum in rats.

Assessing Morphological Diversity of Acinic Cell Carcinoma of Salivary Glands at a Tertiary Care Hospital in Pakistan.

Acinic cell carcinoma (AciCC) is a rare clinical entity and a salivary gland malignancy. It is associated with wide histological variations in the cytomorphological patterns. Sixty cases diagnosed as AciCC from 2002 to 2023 were assessed for diverse cytomorphological patterns. The mean age of patients at the time of diagnosis was 44.35±16.8 years ranging from 15 to 81 years. Females comprised 58.3% for a F: M ratio of 1.4:1. Fifty three cases (88.3%) occurred in the parotid gland, two cases in the nasal region (3.3%), and one case each in the soft plate and upper lip (1.7%). The location of the remaining three cases was not specified. The most common presenting complaint was a well-defined facial swelling associated with pain. The average tumor size was 3.8±1.9 cm. The most predominant architectural pattern was solid (83.3%) followed by microcystic (60%), then follicular (41.7%), papillary cystic (14.3%), and tubulocystic (28.6%), and AciCC with de-differentiation/high-grade transformation was reported in three cases (5%). In 83.3% of the cases (50 out of 60), we noticed a mixture of two or more growth patterns.Other degenerative changes included prominent lymphoid stroma, hemorrhage, and cystic change. Awareness and recognition of diverse cytomorphological patterns of AciCC, especially in institutions of a developing country where there is limited availability of highly specific and sensitive immunohistochemical stains or molecular diagnostics, are crucial and essential.

Repeat Single-Session Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations: A Systematic Review, Meta-Analysis, and International Stereotactic Radiosurgery Society Practice Guidelines.

Repeat stereotactic radiosurgery (SRS) for residual arteriovenous malformations (AVMs) can be considered as a salvage approach after failure of initial SRS. There are no published guidelines regarding patient selection, timing, or SRS parameters to guide clinical practice. This systematic review aimed to review outcomes and complications from the published literature to inform practice recommendations provided on behalf of the International Stereotactic Radiosurgery Society. We performed a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of MEDLINE, Scopus, Web of Science, and Embase was conducted. Fourteen studies with 925 patients met the inclusion criteria. Patients were treated between 1985 and 2022. All studies were retrospective, except for one prospective cohort. The median patient age at repeat SRS ranged from 32 to 60 years. Four studies (630 patients) reported detailed information on Spetzler-Martin grade at the time of repeat SRS; 12.54% of patients had Spetzler-Martin grade I AVMs (79/630 patients), 46.51% had grade II (293/630), 34.92% had grade III (220/630), 5.08% had grade IV (32/630), and 0.95% had grade V (6/630). The median prescription doses varied between 15 and 25 Gy (mean, 13.06-22.8 Gy). The pooled overall obliteration rate at the last follow-up after repeat SRS was 59% (95% CI 51%-67%) with a median follow-up between 21 and 50 months. The pooled hemorrhage incidence at the last follow-up was 5% (95% CI 4%-7%), and the pooled overall radiation-induced change incidence was 12% (95% CI 7%-20%). For an incompletely obliterated AVM, repeat radiosurgery after 3 to 5 years of follow-up from the first SRS provides a reasonable benefit to the risk profile. After repeat SRS, obliteration is achieved in the majority of patients. The risk of hemorrhage or radiation-induced change appears low, and International Stereotactic Radiosurgery Society recommendations are presented.

Pathological and biochemical investigation of the effects of Silybum marianum against Methomyl damage in broiler liver

This study was aimed to investigate the protective/preventive and/or curative effects of Silybum marianum seed powder against Methomyl toxication by examining some biochemical parameters and pathological changes hepatic in broiler chicks fed with feeds supplemented with Methomyl and S. marianum seed powder. For this purpose, 4 different groups, each containing 32 animals, were used; Control group (CONT), Methomyl group (MET), S. marianum seed powder group (SMT) and Methomyl + S. marianum seed powder group (MET+SMT). In the study, Methomyl was added to the feeds as 20 ppm and S. marianum seed powder as 10 g·kg-1. The trial period was planned as 28 days, and necropsies of animals from each group were performed daily, and samples were taken for histopathology and biochemistry. In the study, liver enzyme activities and liver tissue oxidative stress markers GPx, MDA and SOD values were found to be similar in the CONT and SMT groups, but statistically higher in the MET group. In the MET+SMT group, the increased parameters were lower than the MET group. The histopathological examinations of liver sections, hyperemia, hemorrhage, hydropic degeneration and fatty changes of hepatocytes, focal necrosis, dissociation of remark cords, mononuclear cell infiltration in the portal area and bile ducts hyperplasia were detected. It has been observed that S. marianum given for preventive/healing purposes reduces histopathological damage and contributes positively in all groups. It has been concluded that S. marianum can be added to poultry diets against Methomyl residues or contamınatıons according to thıs study.

Characteristics of optic disc hemorrhage and optic nerve changes following acute primary angle closure

IntroductionAcute primary angle closure (APAC) is an emergency ophthalmic presentation and a major cause of irreversible blindness in China. However, only a few studies have focused on the characteristics of optic disc hemorrhage (ODH) during an APAC attack, including its shape, depth, location, scope, and duration after intraocular pressure (IOP) control, along with changes in the optic nerve. This study aimed to analyze the characteristics of ODH and optic nerve changes in patients during their first APAC episode.MethodsThis retrospective study involved 32 eyes from 32 patients with APAC who received sequential treatment and analyzed the following parameters: the highest IOP and its duration, ODH, retinal nerve fiber layer thickness (RNFLT), and mean deviation (MD). We compared parameters obtained from the affected eye (ODH group) and contralateral unaffected eye (control group), as well as intragroup comparisons.ResultsThe mean IOP in the ODH group was 64.28 ± 10.36 mmHg, with a duration of 4.44 ± 2.35 days. Flame and splinter shapes accounted for 84.38% of the ODH. The mean ODH duration was 4.81 ± 3.25 weeks. ODH during APAC was isolated to one sector in 59.38% of cases, mostly occurring in the temporal superior and temporal inferior (each accounting for 21.88% of the cases). There was a positive correlation between the extent of hemorrhage and the highest IOP duration (p &amp;lt; 0.001). RNFLT was significantly thickened within 72 h post-IOP control but was thinned by 2 weeks. By 6 months, the thinning stabilized, and there was no difference noted between the ODH and control groups at 12 months. MD partly improved at 6 months post-IOP control, and ODH scope significantly affected the MD (p &amp;lt; 0.001). The duration of high IOP was positively correlated to the ODH scope and MD damage.DiscussionTimely and effective IOP management is essential for recovering visual function following an APAC attack.

Effect of &lt;i&gt;Tinospora cordifolia&lt;/i&gt; Leaf and Stem Aqueous Extracts on Zidovudine (ZDV) Induced Hematological Changes in Rat Model

The present study aims to evaluate the protective role of aqueous extracts of stem and leaves of Tinospora cordifolia (AELTC and AESTC) on the hematologic toxicity effects of ZDV in Rats. A Soxhlet extractor was used to prepare separate aqueous extracts of stem and leaf. Twenty-four albino rats (weighing 200-230 g) were separated into four groups. Group I rats were administered distilled water (negative control). Group II rats were administered 500 mg/kg b.w of ZDV (positive control), Group III rats were administered 500 mg/kg b.w. of AELTC along with ZDV, and Group IV rats were administered 500 mg/kg b.w of AESTC along with ZDV. The hematological parameters of the rats were assayed during the 2nd, 4th, 6th, and 8th weeks of treatment. The animals exposed to Zidovudine showed a significant decrease in Red Blood Cells (RBC), Hemoglobin (Hb), White Blood Count (WBC), and platelet count compared to control (Group I). The results of T. cordifolia leaf and stem administered rats showed a significant elevation in RBC, Hb, WBC, and platelets count. Spleen histology showed immunological and hemorrhagic changes with an accumulation of RBCs and severe depletion of lymphocytes in white pulp were observed in ZDV-treated rats. The intake of AELTC and AESTC showed apparent changes in Spleen tissues. These results suggest that AELTC and AESTC stimulate the hematopoietic system, thereby increasing blood cell levels in ZDV-treated rats.

Characterization of Pediatric Infratentorial Arteriovenous Malformations: A Retrospective, Multicenter Cohort Study.

Infratentorial arteriovenous malformations (AVMs) harbor different characteristics compared with supratentorial AVMs. This study aims to explore the unique characteristics of pediatric infratentorial AVMs and their response to single session stereotactic radiosurgery (SRS). The International Radiosurgery Research Foundation database of pediatric patients with AVM (age <18 years) who underwent SRS was retrospectively reviewed. Baseline demographics, AVM characteristics, outcomes, and complications post-SRS were compared between infratentorial and supratentorial pediatric AVMs. Unfavorable outcome was defined as the absence of AVM obliteration, post-SRS hemorrhage, or permanent radiation-induced changes at last follow-up. A total of 535 pediatric AVMs managed with SRS with a median follow-up of 67 months (IQR 29.0-130.6) were included, with 69 being infratentorial and 466 supratentorial. The infratentorial group had a higher proportion of deep location (58.4% vs 30.3%, P = <.001), deep venous drainage (79.8% vs 61.8%, P = .004), and prior embolization (26.1% vs 15.7%, P = .032). There was a higher proportion of hemorrhagic presentation in the infratentorial group (79.7% vs 71.3%, P = .146). There was no statistically significant difference in the odds of an unfavorable outcome (odds ratio [OR] = 1.36 [0.82-2.28]), AVM obliteration (OR = 0.85 [0.5-1.43]), post-SRS hemorrhage (OR = 0.83 [0.31-2.18]), or radiologic radiation-induced changes (OR = 1.08 [0.63-1.84]) between both cohorts. No statistically significant difference on the rates of outcomes of interest and complications were found in the adjusted model. Despite baseline differences between infratentorial and supratentorial pediatric AVMs, SRS outcomes, including AVM obliteration and post-SRS hemorrhage rates, were comparable amongst both groups. SRS appears to have a similar risk profile and therapeutic benefit to infratentorial pediatric AVMs as it does for those with a supratentorial location.